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Five-Step Treatment Approach for Chronic Asthma

Physician-developed and -monitored.

Original Date of Publication: 01 Jun 2000
Reviewed by: Stanley J. Swierzewski, III, M.D.
Last Reviewed: 04 Dec 2007

Original Source: http://www.pulmonologychannel.com/asthma/five-step-treatment.shtml

Home » Asthma » Five-Step Treatment Approach for Chronic Asthma


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Five-step Treatment Approach for Chronic Asthma



Treatment for chronic asthma is based on a five-step approach. The initial objective is to abolish symptoms and normalize lung function, then adjust medication appropriately in response to changes. The outline below generally describes the stepwise approach, which is often modified to suit the patient.


Classification Long-Term Control Medication Quick-Relief Medication
Mild intermittent None Bronchodilator as needed, up to 3–4 times/day
Mild persistent Cromolyn sodium, nedocromil, low-dose inhaled corticosteroid, possible leukotriene modifier Bronchodilator as needed, up to 3–4 times/day
Moderate persistent Medium-dose inhaled corticosteroid alone and with cromolyn sodium or nedocromil, leukotriene modifier, long-acting bronchodilator such as theophylline or long-acting beta2 agonist Bronchodilator as needed, up to 3–4 times/day
Severe persistent High-dose inhaled corticosteroids, oral corticosteroids; high-dose inhaled corticosteroids plus leukotriene modifier, plus long-acting bronchodilator, plus leukotriene modifier, plus long-acting bronchodilator Bronchodilator as needed, up to 3–4 times/day
Step up or down as needed


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